Provider Demographics
NPI:1841696051
Name:THE PREMIER HEALTHCARE NETWORK, LLC
Entity type:Organization
Organization Name:THE PREMIER HEALTHCARE NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-390-9757
Mailing Address - Street 1:1620 GATEWAY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2275
Mailing Address - Country:US
Mailing Address - Phone:615-740-5347
Mailing Address - Fax:
Practice Address - Street 1:1620 GATEWAY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2275
Practice Address - Country:US
Practice Address - Phone:615-740-5347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAA1737OtherMEDICARE ACO-CMS